CHAPTER 1: OVERVIEW OF ● Emotional health - the ability of an

EDUCATION ON HEALTH CARE AND individual to cope with stress and strain as
CHANGE one faces the realities and challenges of life.
HEALTH EDUCATION DEFINED ● Mental health - the ability of an individual
to make correct judgments or sound
Health education refers to the act of
decisions to cope with situations or
providing information and learning
conditions affecting her daily activities.
experiences for purposes of behavior change
and improved for health of the client. ● Social health - the ability of an individual
to relate well with others regardless of status
The acquisition of knowledge through
or position.
exchange of information from the teacher
and the learner facilitates better ● Spiritual health - recognizes the
understanding of the need for change. supernatural aspect of divine healing and the
individuals' communion with his/her
Health education is the totality of
creator.
experiences which favorably influence
habits, attitudes and knowledge relating to The process of health education has certain
individual, community and racial health key aspects:
(Health Education: 2006).
1. It is a planned opportunity of learning
According to the Joint Committee for through information about health guided by
Health Education (2005), specific goals, objectives, activities and
evaluation criteria.
health education is "a process with
intellectual, psychological, and social 2. It occurs in a specific setting.
dimensions relating to activities that
3. It is a program of series or events that
increase the abilities of people to make
introduces concepts at appropriate learning
informed decisions affecting their personal,
levels.
family and community wellbeing. The
process, based on scientific principles, 4. It is based on what was previously
facilitates learning and behavioral change in learned in order to determine what is to be
both health personnel and consumers, learned in the future.
including children and youth." 5. It comprehensively emphasizes how the
various aspects of health interrelate and how
health affects the quality of life.
THE PROCESS OF HEALTH
EDUCATION 6. It includes interaction between the
qualified educator and learner.
Health education consists of learning
experiences that promote behavior
conducive to good health. Effective health instruction interrelated
● Physical health - learning experiences that issues: "what to teach and how to teach
help promote the ability of the body to it."
function accordingly.
Health educators plan and conduct health 2. Used to Modify or Continue Health
teachings for the following purposes, which Behaviors as Necessary
is for clients to:
Health education determines the role of an
1. Be aware of the values of health; individual to be self-reliant and assume self-
responsibility improvement of health and
2. Develop the skills in the promotion and
personal health assessment.
maintenance of health;
It also determines strategies for health
3. Acquire and apply concepts and
maintenance and risk reduction, identifies
information received;
short and long-term consequences of various
4. Develop and discuss opinions regarding behaviors, and demonstrates strategies for
health; and improving and maintaining personal, family
5. Formulate accurate and effective and community health.
decision-making. 3. Provides Health Information and
Services

PURPOSE OF HEALTH EDUCATION Health education provides health

information, products and services in the
Health education aims at more than merely maintenance of good health.
the dissemination of information regarding
good health practices and disease treatment. It also demonstrates the ability to evaluate
It serves several vital purposes in society, resources from home, the school and the
such as the following (Creasia and Parker: community that provide health information.
2007): Health education, also, demonstrates the
1. A Means of Propagating Health roles and responsibilities of school and
Promotion and Disease Prevention community health services to self and
others.
It serves to analyze how environment and
personal health interrelate in ways that 4. Emphasizes Good Health Habits and
enhances health, thereby reducing client Practices as an Integral Aspect of
risks. Culture, Media and Technology

Health education is also concerned with Health education evaluates the influence of
how lifestyle, family history and other risk culture on the health behaviors and care
factors relate to the cause or prevention of services which people get from healthcare
diseases and other health problems. providers.

Health education analyzes how prevention It evaluates the effect of media, technology
and control of health problems are and other factors on personal, family, and
influenced by education, research, and community health.
advances in technology in all health-care Health Education analyzes information
areas. It explains the impact of personal necessary in reaching out to people in the
health behaviors on the functioning of body community to facilitate understanding and
systems. compliance with what is being taught geared
towards self-reliant behavior.
5. A Means to Communicate Vital c. Society and Environment.
Information to the Public
An environment in which health choices
Health education helps the family, peers, dotare made.
and others to communicate their needs,
This is concerned with subnational,
wants and feelings effectively to enable
regional, and local within education
them to resolve health conflicts and
policies, which are often pursued and
problems.
implemented without considering health
This is done to communicate care, consequences.
consideration and respect for themselves
and others.
DIMENSIONS OF THE HEALTH
It also helps analyze possible causes of
EDUCATION PROCESS
conflict and in the formulation of strategies
for solving interpersonal conflicts without Health education is a complex process that
harming oneself or others. requires eclectic knowledge, skills, and
values on the part of the educator
6. It is also a form of Advocacy
Heidgerken (1971) described the 4
Health education is a means to work
dimensions of the educative process,
cooperatively with people in advocating
namely:
health to individuals, families, schools, and
communities. ● substantive or curricular dimension
It is the ability of the nurse to convey health ● procedural or methodological dimension
messages and use effective communication ● environmental or social dimension
techniques to a particular group of people,
influences these clients in making positive ● human relations or interactional
health choices, and make use of strategies to dimension
overcome barriers when discussing about
information, ideas, feelings, and opinions on
health issues. 1. Substantive or Curricular Dimension
-refers to the subject matter specific to
nursing education and is best embodied by
TYPES OF HEALTH EDUCATION the phrase with "what is taught and what is
a. Biological. learned".
Information about human biology and -also refers to providing opportunities for
hygiene. nursing students to acquire essential
knowledge, skills and attitudes that will
The nurse provides health information about prepare them for professional duties and
the human body and how to take care of it. responsibilities in actual nursing practice.
b. Health Resources.
Health services which direct the individual
2. Procedural or Methodological Dimension
regarding the "sensible" use of health care
resources.
-consists of strategies or methods of effectiveness of the teaching and learning
teaching which motivate students to learn. process. It includes the following:
Some of the more common challenges a. The learners who are the recipients of
encountered by teachers in dealing with knowledge.
students in the course of the learning
b. The teacher as the source of knowledge.
process are as follows:
c. Administrator, who are the resource
a. Choice of the most appropriate methods
allocator.
in helping the students learn;
d. Group of learners, who use the holistic
b. Identification of the method most likely
knowledge in a discipline.
to lead and direct learners in their own
learning; and e. Patient, as end-users of nurses' teaching
and learning experiences.
c. Initiation of ways that continue the
lifelong process of learning. f. Nursing Service Personnel knowledge of
and training support for students.
3. Environmental or Social Dimension
g. Allied health personnel and their group
-refers to physical and social factors in the
interaction.
teaching-learning situation. It also refers to
extrinsic factors that capture the interest of
the learner. ASPECTS OF HEALTH EDUCATION
In turn, it makes students adapt to varying 1. Behavioral Sciences
changes in order to see the difference
between what is ideal from what is real. The behavioral sciences which incorporate
psychology, sociology and cultural
Physical factors refer to the actual setting anthropology, are concerned with how
where learning takes place, including the people behave and why they behave in a
following: particular way (Feldman: 2006).
a. The classroom, equipped with audio- They define the primary determinants of
visual materials; behavior as follows:
b. Laboratory settings, such as skills a. Psychological predispositions:
laboratory, RLE laboratory commensurate
with the number of students and consistent such as attitudes, knowledge, beliefs, skills,
with the standards of nursing education; and experiences;

c. Home-based and modern or traditional b. Environmental reinforcement:

hospital set-ups; and family, friends, authority figures, and
d. Community health agencies. associates; and

4. Human Relations Dimension c. Socio-cultural context:

-takes into account the relationship of the sustained societal norms such as attitudes
nurse educator with individuals involved in and behavior.
nursing care practice, which influences the
Behavior change is a desired outcome of decisions and change social conditions in
health education; ways that are health enriching.
hence primary behavioral determinants are Among its many aims are the following
crucial to the practice of a nurse as health (Breckon: 1994):
educator and clients as recipients of health
1. Enhance knowledge awareness
care
Provides guidance and instruction to all that
2. Public Health
will help individuals or group of individuals
Health promotion is a common function in maintain a high level of wellness.
public health agencies.
2. Promotes health, safety, and security of
Health education relies on public health and the people.
health statistics for epidemiologic
Promotes personal hygiene, environmental
information.
sanitation, and maintenance of a hazard-free
Determinants of health problems include the environment for one to avoid illnesses,
environment, medical care, personal accidents and reduce mortality rate.
lifestyle which are often discovered in the
3. Develop and improve community
public health realm.
resources.
Other issues, such as population dynamics,
Help individuals gain knowledge, and
epidemiology, and biomedical science are
understanding of the different community
deeply rooted in public health.
health agencies who can provide health care
3. Education services.
-refers to the study and practice of teaching Likewise develop habits, attitudes, and
and learning which plays a vital role in the ideals that will help them live as healthy
development of health education. individuals and members of the community
and share the task of community building
Learning theory, development, pedagogy,
and health care.
educational psychology, human andragogy,
curriculum development, measurement, and 4. Increase productivity and strength of
testing are all rooted in the education character.
literature
Help develop productive individuals who
can adjust successfully and live happily with
social groups to which they belong.
Health education further enhances coping
patterns that minimize the effects of stress
IMPORTANCE OF HEALTH on individuals and family.
EDUCATION
5. Disease prevention.
Health education is a system of teaching and
Promotes individual and public health
learning process. It facilitates common
awareness on prevention of disease using
understanding among people in a social
various health care strategies and for the
structure to modify behaviors, make
state to be the home of healthy and Change is a necessary ingredient to modify
productive citizens, or improve teaching and learning to attain
progress. This can be done through
6. Minimize cost.
identification and discussions with a specific
Health education enables the government to group of people and areas that need change.
attain health objectives at least cost.
2. Initiate group interaction
Knowledge and awareness of the people
The teacher must initiate and motivate
regarding health promotion and disease
students to think critically of nursing
prevention minimize health care cost.
situations which will help them build a
7. Self-reliant behavior. framework for problem-solving processes,
Health education provides information and which calls for the following responses:
services necessary in fostering independent a. Identify external and internal forces for
behaviors or self-care attitude conducive to change;
health.
b. State the problem;
c. Identify constraints;
THE CHANGE PROCESS
d. List change strategies or possible
Change is inevitable in all aspects of human approaches to problem solving;
life, hence there is continuing need to
e. Select the best change strategy;
reevaluate and improve the educational
process in order to meet the evolving needs f. Formulate the plan for implementation;
of learners. and Develop or select tools for evaluating
change
School administrators and educators need to
familiarize with current trends, issues, and 3. Implement the change one step at a time.
practices related to both nursing and
Change must be done gradually, one at a
teaching practice.
time in order to have an orderly and
This way, teachers may be able to provide systematic process of change and to
effective ways that will equip learners with safeguard undesirable adverse effects of
vital knowledge and skills in facing the change.
challenges of life.
Abrupt change can create further resistance
The following guidelines may help affect or fear of change.
change in learners:
4. Evaluate the overall results of the change
1. Perceive the need for change process and make further adjustments
Teachers and students must be able to assess Change helps students identify strengths and
their own need for change. Progress requires weaknesses so as to provide remedial
modification, improvement or replacement measures and allow the gradual process of
of obsolete knowledge through re-education change to occur with less problems or
and training. difficulty on the part of the teacher and the
learners.
 Following are barriers to change:
MANAGING CHANGE 1. Culture
Considering how far-reaching the effects of Culture determines the beliefs and values
change can be, it is important to identify a important to the learner that may delineate
particular management strategy for change her potential development for change.
(Jones: 2007).
Some cultures compete with change, other
1. Thinking-Practice Strategy welcome change while some resist change.
Thus, the socio-cultural background and the
This is a strategy which assumes that
learners' personal characteristics influence
learners are rational beings with mental
the process of change.
faculties and behave according to their
personal beliefs, interests and motivation.
2. Interest and Commitment Strategy
This strategy assumes that learners always
act consistently with their desire to change
2. Demographics
and commitment to Socio-cultural norms of
behavior. This pertains to the learner's age, gender,
heredity, and environment which may
They are therefore willing to change for
determine innate qualities and potentials as
purposes of acceptance and recognition. It is
well as tendencies and level of response of
a self-made process and the extent of
the learners to a learning stimulus.
learning depends on the learners'
prospective goals of behavior change. 3. Socio-economic Conditions and
Environmental Circumstances
3. Power and Self Discipline Strategy
This may involve the learners' adaptability,
This is a strategy which makes learners
flexibility, and capabilities in creating
comply with instructions given by the
change that may influence the quality and
teacher as an authoritative figure in order to
quantity of response to the change process.
bring about change. It is more traditional in
style as it often demotivates students and The learners' position in the community,
could make teaching and learning processes social interactions and economic status
offensive (Bradshaw and Lowenstein: greatly affects much of the learners'
2007). response to change.
4. State of wellness and development
FACTOR AFFECTING CHANGE The learners' state of well-being and
development relates to his physical,
Change is part of learning desired by both
emotional, intellectual and spiritual health.
the teacher and the learner.
This affects the instinctive qualities of the
However, constraints and difficulties are
learners' response to a stimuli and capability
often encountered as the learner undergoes
of coping with stress related situations.
the process of change.
CHANGE AND ITS EFFECT ON THE patient's body, and anointing with oil,
FILIPINO HEALTH VALUE SYSTEM flagellation, or isolation.
Based on a list of change barriers, the In the laying of hands, it appears as if the
Philippines is a classic example of how healer is transferring the healing energy
large scale change can influence the state of from his or her hands to the patient's
the health care system. afflicted body part.
Following are some medical health remedies Typically, the patient attests to the energy
used by Filipinos: that seems to enter the body and provides
instant well-being.
1. Home Remedies
4. Regulated Drugs or Medicines
One remedy is the use of oils or ointments,
often Chinese in origin, which serve as These are research-based drugs commonly
"cure-alls" for relaxing, heating, and referred to as regulated "prescription
comforting the muscles or providing relief drugs".
for dizziness, colds, headaches, and sore
They require prescription from doctors due
throats, among others.
to expected adverse effects. These are
These include simple touch, adequate rest, mostly produced and manufactured by
light massage or effleurage, salt gargle, pharmaceutical companies.
increased water intake, and ventilated
5. Over-the-Counter Drugs
rooms, among others.
These are non-prescription drugs or
2. Traditional Healing Techniques
medicine mostly produced and
The use of herbal medicinal leaves such as manufactured by multinational
"lagundi", "banaba', "pito-pito" and other pharmaceutical companies.
sources like the bark of trees and stem of
They can be bought by a patient from the
plants which provide relief.
counter without prescription from the
These can be used in the treatment of physician.
various diseases and disorders in the
Examples of these are analgesics or
absence of western medical intervention or
antipyretics, paracetamol, ibuprofen,
medical equipment.
antacids, and laxatives, among others.
3. Supernatural Healing or the Use of Faith
Healers
Chapter 2 : CONCEPTS OF TEACHING
Supernatural healing is a holistic and
AND LEARNING
uniform approach to healing, which
incorporates belief in the concurrent DEFINITION OF TERMS
physical, emotional, and spiritual state of 1. Education
the patient.
Education is an interactive process of
Faith healing uses techniques which include imparting knowledge through sharing,
blessing of the body with holy water, explaining, clarifying and synthesizing the
prayers and devotions, laying hands on the substantive content of the learning process
in order to arrive at a positive judgment and 3. Learning
well-developed wisdom and behavior
Learning is the acquisition of knowledge of
(Kozier: 2004).
all kinds such as abilities, habits, attitudes,
Education is likewise an application of values and skills (Calderon: 1998) primarily
several teaching and learning principles to create change in an individual. It is a
which comprise a body of knowledge and gradual, continuous process throughout life.
research findings ultimately meant to result
4. Patient Teaching
in the formation of expected behavior of an
individual (Heidgerken: 1971). Patient Teaching is a basic function of
nursing, the concept of patient teaching is
Education must provide adequate learning
perceived as a legal and moral requirement
opportunities which allow individual to an
of licensed nursing personnel and defined
demonstrate lifelong values which enable
as a system of activities intended to produce
her to contribute fully to the development
learning and change in client health
of a peaceful and just society
behavior (Nursing Fundamentals: 2012).
2. Health
It is a dynamic interaction between the
Health is a sense of being physically fit, nurse as the teacher and the patient as the
mentally stable and socially comfortable. It learner. The nurse provides all the needed
encompasses more than the state of being information for patients or clients to acquire
free of disease (Kozier: 2004). knowledge, and the patient as the learner
internalizes these information as basis for
According to WHO, health is a "state of
his daily routines and activities for
complete physical, mental and social well-
promoting and maintaining health.
being and not merely the absence of disease
or infirmity." This encompasses the ability 5. Teaching
of an individual to perform tasks expected
Teaching is the process of providing
even if some manifestations of illness are
learning materials, activities, situations, and
felt.
experiences that enable the clients or
It is a condition that permits optimal learners to acquire knowledge, attitudes,
functioning of the individual to live most values and skills in order to facilitate self
and to serve best in her personal and social reliant behavior.
relationship (Sharman: 1948)
Teaching is a consequential process, where
Health for Hildegard Peplau is the process the teacher demonstrates and the learner
by which an individual strive for a stable appreciates what is shown and to internalize
equilibrium and a forward movement of the what is in seen and felt.
personality. It is the ability of an individual
THE EDUCATION PROCESS
to adapt to constant change which will
make life easier and faster. The education process is and learning
(Bastable: 2007).
For Faye Abdellah, health means a state
when an individual has no unmet needs and It is a cycle that involves a teacher and a
no anticipated or actual impairment of the learner. A teaching-learning process occurs
body. before the lesson begins and continues after
the last lesson ends. This includes the ● It is constructive and objective with the
following: purpose of creating effective change in the
behavior of both the teacher and the learner
1. Assessment
in terms of input, process and output.
● It is a process which provides the nurse
THE NURSING PROCESS
educator with information regarding the
learners' knowledge and skills needed to The nursing process provides the necessary
efficiently and effectively transfer tool to enable the nurse to render quality
knowledge and skills to the learners. nursing care to patients. It helps determine
the clients' health needs. It emphasizes the
● It also refers to the gathering of data
need to manage and maximize health by
about the learner or A group of learners'
managing risk factors and encouraging
demographic profile, skills and abilities
healthy behavior.
needed in identifying the most appropriate
teaching strategy. The nursing process is a scientific and
systematic, problem solving approach used
2. Planning
to identify, prevent and treat actual or
● It is a carefully organized written potential health problems and promote
presentation of what the learner needs to wellness. It provides framework in which
learn and how the nurse educator is going nurses use their knowledge and skills to
to initiate the teaching process. express human caring.
● It includes culturally-relevant skills for The nursing process is an orderly,
the learner, the A goals of learning. type of systematic manner of determining the
teaching-learning setting such as: client's problems, making plans to solve the
classroom, laboratory, clinical, or ward problems, initiating the plan or assigning
setting. others to implement the plan, and
● It indicates teaching timeline and specific evaluating the extent to which the plan has
sets of learner activities. effectively resolved the problems identified
(Kozier: 2004).
3. Implementation and Application of the
Teaching Plan
● The point where the theoretical and
practical aspects of the teaching-learning
process meet as the teacher applies the plan.
● This includes procedures or techniques
and strategies that the teacher will use to
best implement the plan.
4. Evaluation
● The measurement of the teaching- PURPOSES OF THE NURSING
learning performance of both the teacher PROCESS
and the learner.
1. Provides a tool to enable the nurse to
render quality-nursing
2. Helps identify the client's health care CHARACTERISTICS OF THE NURSING
needs, and determine care to clients. PROCESS
priorities of care and expected outcomes.
1. Systematic
3. Establishes nursing intervention to meet
The nursing process has an ordered
client-centered goals.
sequence of precise and accurate activities.
4. Provides nursing interventions to meet Preceding activities influence activities
the needs of clients. following them.
5. Evaluates the effectiveness of nursing 2. Dynamic
care in achieving client goals.
The nursing process provides active
6. Achieves scientifically-based, holistic, interaction and integration among activities.
and individualized care. Current activity is necessary to influence
future activities.
7. Takes the opportunity of working
collaboratively with clients and other 3. Interpersonal
members of the health care team.
The nursing process ensures that nurses are
8. Achieves continuity of care to the clients. client-centered rather than task-centered.
The nursing process encourages nurses to
work and help clients use their strength to
NATURE OF THE NURSING PROCESS meet their own needs.
1. The nursing process is dynamic and 4. Goal-directed
cyclic. Each step may be reviewed and
The nursing process is a means for nurses
revised according to changing client
and clients to work together in order to
responses to nursing interventions, which
identify specific goals related to wellness
may require revisions in the plan of care.
promotion, disease and illness prevention,
2. It is planned and goal-directed. The plan health restoration and coping with altered
of care and nursing intervention is functioning.
organized carefully one to meet the client's
5. Universally Applicable
goals of care.
The nursing process allows nurses to
3. It is an intellectual process. Nurses use
practice nursing with well or sick people,
knowledge in problem solving, decision-
young or old, regardless of race, creed or
making and critical thinking to assess their
religion and in any practice setting.
client's problems, plan their care,
implement plans, and evaluate the STEPS IN THE NURSING PROCESS
effectiveness of the care given.
Following are the steps in the nursing
process (Kozier: 2004)
1. Assessment
Assessment includes gathering of data
about the system, the individual, family, or
community and recording of all needed
information. Data are gathered through outcomes and goals. Nurses document this
interview, physical examination, research plan in appropriate forms such as nursing
and review of records. progress notes".
Purposes of Assessment They put the plan into action in order to:
● Predict, detect, prevent, manage or ● Assess appropriateness of intervention.
eliminate health problems.
● Perform interventions.
● Clarify expected outcomes.
● Make immediate changes.
● Develop specific plan.
● Chart and monitor progress of clients.
● Review of Records. Nursing assessment
4. Evaluation
involves data gathering about the patient
from a variety of sources. Evaluation involves the collection of
pertinent and reliable data about the process
● Initiates the intellectual process in sorting
and outcome of care. The quality of nursing
and classifying gathered data, recognizing
care that is provided is analyzed and results
patterns and discrepancies comparing these
are compared with expected outcome
with norms and identifying client response
criteria.
to health problems that are amenable to
nursing interventions (Kozier: 2004). 6. Documentation
2. Planning Documentation establishes a written record
of assessment, the care provided and the
Planning is the formulation of the nursing
patient's response which is an integral part
care plan on which the nurse works with the
of each step of the nursing process
client to set goals and objectives and predict
outcomes. Planning identifies nursing
actions for preventing, correcting, or
relieving health problems and developing
specific interventions as stated in the EDUCATION AND THE NURSING
nursing care plan. PROCESS DIFFERENTIATED

Planning is done in order to: The education process is often confused

with the process because both have the
● Detect, prevent and manage health same elements such as assessment,
problems. planning, implementation and evaluation.
● Promote well-being and anticipate The two are however different in terms of
potential problems. focus.
● Allocate and utilize possible resources to Nursing process focuses on planning and
achieve desired outcomes. implementation of care based on the
assessment and diagnosis of physical and
3. Implementation
psychosocial needs of a client, while the
Implementation is the actual performance education process focuses on the planning
of the plan. This helps determine client's and implementation of teaching based
progress towards meeting expected assessment and prioritization of learning
needs, readiness to learn and learning styles 1. The primary source of knowledge of
of the learners. learners in nursing;
IMPLICATIONS OF THE CONCEPTS OF 2. The primary catalyst for the learning
TEACHING AND LEARNING IN process; and
NURSING PRACTICE
3. A role model for learners,
Planning of patient care is a complex
4. An active facilitator, who demonstrates
process involving several individuals. It is
and teaches patient care to nursing students
designed to achieve specific goals like
in the classroom and clinical settings;
health promotion or improvement.
5. A source of health care information and
Nursing is synonymous to "care" where the
care to clients and
nurse responsibility is beyond care for the
patient by doing his or her clinical duties 6. Is diligent; keeps abreast of
such as giving comfort measures and developments in his or her field through
administering treatment modalities. These continuing education, reading of nursing
include cleaning of wounds, changing journals and online materials and active
patient's clothes, ensuring that prescribed participation in workshops and seminars.
medicines are taken on time with the
accurate dosage among others (Creasia and
Parker: 2007).
Nursing also means teaching the patient FUNCTIONS OF A HEALTH
proper self-care, health promotion, illness EDUCATOR
or disease prevention, factors affecting A health educator is a practitioner
health and illness, and treatment options. professionally prepared in the field of
Relatively, it is important to have a clear health education, who demonstrates
understanding of the essence of teaching in competence in both theory and practice and
the practice of nursing. Teaching plays an accepts responsibility in advancing the aims
essential role in the efficient and effective of the health-education process (De Young:
dissemination of information and in 2003).
developing practical clinical skills of
students by means of demonstration, A health educator performs the following:
laboratory activities and similar hands on 1. Collaborates with health specialists and
exercises. civic groups in assessing community health
Chapter 3: ROLES AND needs and availability of resources and
RESPONSIBILITIES OF THE NURSE AS services and in developing goals for
HEALTH EDUCATOR IN TEACHING meeting health needs of clients.
PATIENTS 2. Formulates operational plans and policies
DEFINITION OF A NURSE EDUCATOR necessary to achieve health education
AND HER ROLES objectives and services.

The nurse educator is: 3. Conducts and coordinates health needs

assessment and other public health surveys.
4. Designs and conducts evaluation and PATIENT TEACHING DEFINED
diagnostic studies to assess the quality and
Patient teaching, as defined by the
performance of health education programs.
American Academy of Family Physicians,
5. Plans and implements health education is the process of influencing patient
and promotion programs such as training behavior and producing changes in
workshops, conferences, and school or knowledge, attitudes and skills necessary in
community projects. maintaining or improving health.
6. Prepares and distributes health education Patient Teaching is a holistic process with
materials, such as reports, bulletins, online the goal of changing or affirming patient's
websites and visual aids like films, behavior to benefit health status. Patient
videotapes, photographs and posters. teaching refers to only one component of
patient education process which is giving
7. Provides guidance to agencies and
the patient healthcare information.
organizations in the assessment of health
education needs and in the development Patient teaching is more than imparting
and delivery of health education programs. information. The skilled patient educator
assists the patient in interpreting,
8. Disseminates health program information
integrating, and applying the information
to the public by preparing and issuing press
given. Patient teaching ends with an
releases, conducting media campaigns, and
evaluation of patient learning. It is a
or maintaining program-related websites.
process that occurs overtime, requiring an
9. Promotes and maintains cooperative ongoing assessment of patient's knowledge,
working relationship with agencies and attitudes and skills. Patient readiness or
organizations interested in public health motivation to change behaviors and the
care. obstacles that the patient faces to make a
behavioral change are important factors to
consider (Falvo: 2003).
10. Provides and maintains health education
libraries to provide resources for staff and PURPOSES OF CLIENT TEACHING
community agencies. Nurse Educators teach clients in order to:
11. Formulates, prepares and coordinates 1. Increase clients' awareness and
grant applications and grant-related knowledge of their health status;
activities to obtain funding for health
2. Increase client satisfaction:
education programs and related work.
3. Improve quality of life;
12. Documents activities, records
information such as number of programs 4. Ensure continuity of care;
completed, nursing actions implemented,
5. Decrease patient anxiety;
and individuals assisted.
6. Increase self-reliant behavior;
13. Maintains databases, mailing lists,
telephone networks, and other information 7. Reduce effectively the incidence of
to facilitate the function of health education complication of illness;
programs.
8. Promote adherence to health care and family values and clients' health care
treatment plans; beliefs.
9. Maximize independence in the FACTORS THAT INFLUENCE CLIENT'S
performance of activities of daily living; LEARNING
and
There are several factors that influence
10. Energize and empower consumers to learning at any age. They include the
become actively involved in the planning of following:
their care
1. Stage of Development.
The role of nurses as health educators in
When teaching clients, teaching must be
turn enhance their job satisfaction when
adapted to the client's developmental level
they recognize that their teaching actions
rather than their chronological age.
have the potential of forging therapeutic
Developmental level determines the ability
relationships with patients, allowing for
of the person to learn best, whether by
greater patient-nurse autonomy, raise their
reading printed materials, using computer-
accountability for practice, and create
based applications, watching videos,
change that truly makes a difference in the
participating in group discussions, play or
lives of others.
other methods.
THE ROLE OF THE NURSE IN CLIENT
Teenagers have different concerns from
TEACHING
older adults. Parents and grandparents who
Health teaching is an essential role of must assume long term care may often need
today's nurses. Nurses care for their client, more information that may not have existed
prepare them for diagnostic procedures or during their childhood years.
surgery. Using knowledge of growth and
2. Cultural values.
development, and from nursing theories,
nurses teach individuals and their families The nurse's teaching can be most effective
at various levels of understanding. Clients if norms, traditions and cultural beliefs are
and their families need information as well considered and incorporated into their
as emotional support so they can cope with teaching plan. People have difficulty
the anxiety and uncertainty of client's understanding the subject matter of what is
illness. Nurses also work with the client's being taught if they disagree with the topic
significant others to prepare them to assume and their tendency to disregard if they could
responsibility for care at home after the not reconcile such things with their
client is discharged from the hospital. personal realities.
Education is essential to promote health. 3. Language used.
The nurse applies the principles of teaching The ability of the client to understand the
and learning to change the behavior of language of teaching determines how much
clients and their family members. Nurses they learn. Clients to whom English is not
motivate clients and their families to take the primary language may not understand
charge of and make responsible decisions the use of informal words or medical terms.
about their own health care. For teaching to The nurse must make sure that health
be effective, it must incorporate the cultural instructions
must be understood and used by clients in 1. Assess teaching needs of the client, or
their daily activities. Use clients' own teaching that is required in a particular
language or get an interpreter to help reach situation.
out to their understanding.
2. Assess readiness of the client to learn and
4. Physical environment. The nurse must the relevance of the content must be
consider privacy and confidentiality of considered in order for learning to occur.
information when discussing sensitive
3. Assess what the client knows and begin
issues such as sexuality, drug addiction or
from what she knows.
domestic violence, among others. Focus
group discussions can also facilitate 4. The nurse should consider language
interactive process regarding health barriers, literacy, ethnic, or cultural
concerns or issues affecting all members of background, age and emotional status of the
the group, like sharing experiences they can patient. Otherwise, teaching and learning
expect while in the hospital or at home. can be difficult, placing the patient at risk.
5. Previous experiences. Clients who had 5. Interactive discussions increases
past experiences similar to the current learning. The client should be actively
health problem may need less education involved in the teaching-learning process
since they became familiar with the health and not act as a passive listener or viewer. A
care activities, they had been taught earlier. discussion format in which all can
However, they may have additional participate stimulates more learning than
concerns which requires more health hearing a straight lecture.
teachings. 6. Demonstrate tasks to be done for active
6. Knowledge and skill of the teacher. practice. Repetition of skills increases
retention and promotes a feeling of
The teacher must determine the objectives
competence.
of the subject matter to be taught. Develop a
plan to meet the objectives, and gather all 7. Praises and positive feedback motivates
necessary materials. The nurse must learning. This is important when the client
determine the best method to present the is trying to master a task, such as capillary
materials for the intended audience and later blood glucose test and self insulin injection
summarize all information given in order for for diabetic clients.
the client to develop a holistic idea of the 8. Role modeling is an effective method for
subject matter. demonstrating behavior. Nurses must be
PRINCIPLES OF CLIENT TEACHING aware that their behavior is scrutinized
AND LEARNING carefully at all times and that it may be
copied later.
Education is essential to promote health.
The nurse applies the principles of teaching 9. Conflicts and frustrations impede
learning, and should be recognized by the
and learning to change the behavior of
nurse and resolved for learning to progress.
clients towards making responsible
decisions about their own health care. [Link] teaching and presentation of
Applying the following principles will help simple tasks must be done before complex
nurses become effective teachers. tasks in order to enhance learning. For
example, the nurse teaches the client how to the families understand the process and are
care for the umbilical cord, which is simple involved directly in making decisions and
task, before teaching how to bathe and activities related to their care. The nurse
shampoo the newborn, which is more should be sensitive to the clients' values,
difficult for inexperienced parents. beliefs and customs. The following are
guidelines to therapeutic communication.
11.A variety of teaching methods is
necessary to illustrate concepts and 1. A peaceful and calm environment
maintain interest of clients. Posters, videos, provides privacy, reduces distractions and
models, online and printed materials can minimizes interruptions.
supplement lectures and discussion.
2. Begin interactions by introducing oneself
[Link] information in small segments and nurse's role. This will describe the
over a period of time for better retention nurse's
and appreciation. Short hospital stay do not
purpose and sets the discussion process. For
support this practice, making follow-up
ex. "My name is Crestita Tan, I am here to
care particularly important.
complete the health instructions that was
Complex procedures need to be taught well. started yesterday..
Injection techniques, handouts, visual aids,
3. Therapeutic communication should be
and actual equipment should be used. The
focused and directed towards meeting the
client should demonstrate the learned
needs of clients. For example, Focusing
procedure in order that the nurse can
interactions -"How do you feel about the
evaluate the effectiveness of the teaching
treatment received today? Redirect
process. The substance or content and skills
conversations- "Thanks for showing me the
taught should be documented in appropriate
beautiful family pictures, I understand you
health records. Using these principles
are having a bit of trouble with your kids'.
ensures that the nurse meets the required
standard of care in any nursing situation. 4. Communicate more powerful messages
to the client through non-verbal behaviors
THERAPEUTIC COMMUNICATION
rather than spoken words.
The nurse have to carry out many roles and
● Eye movements and facial expressions
one of the most important role required of
can confirm, or contradict what is said.
the nurse is the skill in therapeutic
communication. Nursing care becomes ● Repetitive hand gestures such as tapping
personal, humane and sensitive to clients' the fingers or twirling hair may indicate
needs if the nurse can effectively frustration. Body posture, stance and gait
communicate and reach out to clients. In can convey energy,depression or
this way, therapeutic communication must discomfort.
be purposeful, goal directed and focused. ● Voice tone, pitch, rate and volume may
GUIDELINES FOR THERAPEUTIC indicate joy, anger or fear.
COMMUNICATION ● Grooming also conveys messages about
As the health professional who is close to the nurses' sel! image.
the client, the nurse informs families of
treatments and procedures, making sure that
● Talking to a young child may require that are sometimes uncomfortable with touch or
the nurse sit or squat to get to the child's are disturbed by unsolicited touching
level. (Kozier 2008).However, Filipinos are very
comfortable with touch and the feelings of
5. Active listening requires that the nurse
safety and security are enhanced by touch.
attend to what is being said as well as to the
non verbal clues. Behavior that convey the
nurse's interest and sincere desire to listen THERAPEUTIC COMMUNICATION
and understand which include the TECHNIQUES
following: Therapeutic communication techniques
● Eye contact signals readiness to interact. involves responding as well as listening,
and the nurse must learn to use responses
● Calm and relaxed posture, with the upper that facilitate rather than block
portion of the body inclined toward the communication. Communication techniques
client. focus on both content of the message and
● Encouraging non verbal cues such as the feelings that accompanies the message.
nodding, smiling and leaning closer. Verbal These techniques include clarifying,
cues include "Go on, uh huh."Tell me about reflecting, being silent, questioning and
that," or "Can you give me an example." directing. In addition, the nurse be aware of
● Touch can be a powerful response when blocks to communication such as conveying
words would break a mood or fail to lack of interest, conveying sense of haste,
convey the depth of feeling experienced closed posture as in hands closed over
between client and nurse. chest, interruptions, providing false
reassurance, inappropriate self disclosure,
● Clarifying communication involves a
giving unsolicited advice and failure to
unique process of the client receiving the
acknowledge comments or feelings. (Wong
message as intended by the nurse. The
et al 2010)
nurse can ask questions if the meaning of
the statement is not clear. For instance, the DOCUMENTATION OF CLIENT
nurse might say `` I'm not sure, I TEACHING
understand you." Communication among members of the
● Emotions are part of communication, and health care team is essential if this is to be
nurses must often reflect feelings that are coordinated and consistent to the principles
expressed verbally and non verbally. The of client teaching. Although communication
nurse might suggest, "You looked forward takes place through word of mouth, another
to going home today but disappointed that method used is documentation of patient
you needed to stay longer for more teaching.
diagnostic workup." Such documentation not only
● Cultural differences greatly influence communicates what is taught to the client
communication. In some cultures such as but also communicates the client's level of
Chinese and Southeast Asian, prolonged understanding, and further reinforcement of
eye contact is considered confrontational information may be necessary (Le Fevre
while Middle Eastern or Native Americans 2005). Such information prevents
redundancy and can assist in the evaluative d. Designs assessment forms to high-risk
process. patients, in order to pinpoint potential
problems that identify specific learning
Characteristics of Documentation in Client
needs.
Teaching
2. Problem List
1. Covers all aspects of patient care;
a. The patient's chart has a list of actual and
2. Critical for communication among team
potential health problems identified
members;
individually or collaboratively. It also
3. Provides a legal record; includes medical and nursing diagnoses;
4. Supports quality assurance efforts; b. The nurse has to enter the data next to
5. Promotes continuity of care; and 6. each problem as it is identified and when
Facilitates reinforcement. the problem is resolved. Standardized care
plans may be generated based on nursing
Good documentation reflects the following: diagnoses.
1. Initial assessment and reassessment of 3. Care Plan or Critical Pathway
pertinent data;
An individualized care plan for each patient
2. Nursing diagnoses and client learning assessment of medical and nursing
needs; diagnoses, patient goals, interventions and
3. Interventions provided; desired outcomes.

4. Client's response and outcomes of care;

4. Flow Sheets (Optional)
5. Discharge plan of care; and
Flow sheets contain observations and lists
6. Ability of the client and family to of patients name and data in a clear,
manage needs after discharge concise, check-off format to encourage fast
and immediate documentation. Findings or
Review of the components of
patient responses outside of normal limits
documentation system illustrates how
must be recorded in the nurses' notes.
documentation of client teaching can be
integrated into the patient record. The The method of charting assumes that all
components are as follows: abnormal findings or variances are charted,
1. Admission Assessment referred to as "charting by exception." If
flow sheets are used to record patient
The nurse educator:
teaching, data entered should be the
a. Make a complete patient profile and documentation of patient's understanding of
history. what was taught rather than the subject
b. Assesses the clients' functional ability to matter being taught.
aid in the formulation of nursing diagnoses. 5. Progress Notes
c. Identifies ways of individualizing Narrative notes show the patient's progress
teaching, such as the client's readiness, perceived by all health care professionals
language, and physical capability. involved in patient care. Evaluation of the
patient's responses to nursing interventions
should be evident. Every problem is
referenced with a number corresponding to
the problem list.
Patient teaching can be effectively
documented in the progress notes section of
the medical record. Patient teaching is a
problem solving process hence,
documentation includes a clear statement of
needs or problems, significant data and the
plan of care. It is also important to
document the outcomes of care. Narrative
notes also encourage charting in patient's
own words to illustrate outcomes of patient
education and evidence of individualized
care.
6. Discharge Summary
Summaries or reports written at the time of
discharge or transfer of the client to another
health care facility serve as needed source
of information for other health care
providers about the patient's needs for
reinforcement of health teaching and
continued learning. Notes and telephone
consultations can be used to communicate
assessments and ongoing learning needs of
clients to continuing care providers.